Emetophobia, Anyone?

Elizabeth Spencer

Emetophobia (fear of vomiting) is common enough to have it’s own name, something most other phobias don’t have. While phobias in general affect 8.7% of people in the US, there aren’t reliable numbers for this sub group. People with Emetophobia can be misdiagnosed as having an eating disorder.   Similarly, I have had clients who have OCD which is partly expressed as Emetophobia, so it can be a part of another diagnosis as well.


Treatment involves exposure to the feared topic in a variety of ways. As always, start with a hierarchy for each client – it always surprises me how clients with the same phobia have such different hierarchies. For example, watching someone throw up in a television show or movie is a 4 anxiety for a ten-year old I have worked with, and an 8 for a middle-aged woman. Then there are surprises that I would not have even suggested we needed to put on the hierarchy, like a woman in her early 20’s who was terrified of the possibility that she would throw up while she was driving, have an accident and die. Before treatment she avoided driving altogether, taking Uber or the metro, or catching rides with friends. It’s always a good idea to ask the client what else they are avoiding in case they have anything else to add to the list!


This summer I have been watching a funny video with everyone I see who has Emetophobia:




Doesn’t that make you want to watch? What could be funny about a video of someone throwing up? We take it slowly. As a beginning exposure I tell the client what to expect, then we watch the first part of the video, which is just dancing. Next or on future exposures, we watch the whole video without sound, and finally with sound and as a full screen. The reaction of the little girl, who throws up, Paula Abdul, who gets thrown up on, and the whole audience, was a revelation to all of my clients.


The ten-year-old client especially had a remarkable change in her ridged fear of throwing up. While she is still scared of what will happen when she actually throws up, she no longer is stuck at home with her mother all the time just in case today is the day. She has a new attitude — it could happen and it might be horrible but people do get through it. The week after she watched the video she went to sleep away camp with no trouble and helped two girls in her cabin with phobias, one afraid of spiders and the other of lightning. She told them, “Your brain is tricking you. Spend time with the thing you are afraid of, don’t run away from it. I’ll help you, we can start small.” Victory!



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